France To Ease Key Drug Prescribing

The French government is to liberalize the prescription and distribution of key innovative drugs. under the new "orange ticket" scheme, expensive drugs such as zidovudine or interferon, which up to now have generally been for hospital use only, will be prescribable by general practitioners and purchased in pharmacies. The aim of the scheme is to prevent an expensive explosion in reimbursement costs and to facilitate access to major drugs.

There is already a "white ticket" scheme for drugs reimbursed at 65% of cost, and a "blue ticket" for those reimbursed at 35%. The orange ticket will apply to drugs which are "exceptional," either in therapeutic quality or price. It will also cover drugs such as cyclosporin, Glaxo's migraine treatment sumatriptan and Lafon's modafinil for the treatment of narcolepsy. The latter two drugs received French marketing approval about two years ago, but the government has reportedly been concerned about their high cost.

A spokesman for the Ministry of Social Affairs said the scheme is really "for major drugs of the future - those that have not yet been discovered." The proposal, which has been formally submitted to the State Council, is expected to go into operation from September, but was immediately attacked by the militant medical organization, the FMF, which said it indicated a lack of confidence in the doctors by the government, and constituted "a provocation to the medical professional and an insult to the professional conscience of the prescribers." The more representative medical groups, MG-France and the SML, said they were not hostile in principle but feared the heavy hand of bureaucracy in some of the detail.